Physician and Practice Characteristics Influencing Tumor Board Attendance: Results From the Provider Survey of the Los Angeles Women's Health Study — JOP

Copyright © 2011 by American Society of Clinical Oncology
Physician and Practice Characteristics Influencing Tumor Board Attendance: Results From the Provider Survey of the Los Angeles Women's Health Study
Kevin S. Scher, MD, MBA, Diana M. Tisnado, PhD, Danielle E. Rose, PhD, MPH, John Lloyd Adams, PhD, Clifford Y. Ko, MD, Jennifer L. Malin, MD, PhD, Patricia A. Ganz, MD and Katherine L. Kahn, MD

+ Author Affiliations

Department of Medicine, University of California, Los Angeles (UCLA), Los Angeles; David Geffen School of Medicine at UCLA, Veterans Affairs Greater Los Angeles Healthcare System, Sepulveda; RAND Corporation, Santa Monica; UCLA School of Public Health, Jonsson Comprehensive Cancer Center, Los Angeles, CA


Corresponding author: Kevin S. Scher, c/o Judith Magee, David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Box 951736, Los Angeles, California 90095-1736; e-mail: Ksscher@gmail.com.


Abstract
Background: Coordination of care has grown in importance with the advent of new modalities of treatment that require specialized expertise. In cancer care, multidisciplinary approaches have shown improvements in quality of care. Tumor boards may provide a mechanism for improving coordination of care. We evaluated physician and practice characteristics that predict frequency of tumor board attendance.

Materials and Methods: This cross-sectional study used data obtained by surveying physicians of a population-based sample of women with incident breast cancer. Physicians were queried regarding tumor board attendance, specialty [medical oncologist (MO), radiation oncologist (RO), surgeon at a hospital with American College of Surgeons accreditation (ACOSSg) and surgeon without such affiliation (non-ACOSSg)], physician characteristics (gender, race/ethnicity, teaching involvement, patient volume, ownership interest) and practice setting (type, size, reimbursement method). Univariate, bivariate, and multivariate analyses were performed for the dependent variable characterizing provider report of frequency of tumor board attendance.

Results: Most surveyed physicians (83%) report attending tumor board weekly (58%) or monthly (25%). Specialty and higher patient volumes are significant predictors of more frequent attendance. Compared with the most prevalent specialty category (low-volume ACOSSgs), high-volume MOs attend more frequently (P = .01) and low volume non-ACOSSgs attend less frequently (P = .00).

Conclusions: Tumor board provides a structure for engaging providers in discussion of cancer cases that is designed to enhance quality of care. Tumor board agendas and formalized institution-wide policies could be designed to engage low-frequency attendees as a means to improve quality measures, promote multidisciplinary care, and potentially improve health outcomes.

Accepted December 7, 2010.
Physician and Practice Characteristics Influencing Tumor Board Attendance: Results From the Provider Survey of the Los Angeles Women's Health Study — JOP